Introduction
The drooping eyelid, or ptosis in technical terminology, is a low position of the upper eyelid. The eyelid cannot be raised arbitrarily. This can be a muscular weakness or caused by a nerve.
A connective tissue weakness of the skin is also possible. Those affected can have restricted vision and often suffer psychologically from the facial malposition. If the drooping eyelid causes complaints, a small, relatively low-risk operation can provide relief.
Cause
Drooping eyelids can have a variety of causes. The most common cause is age. With increasing age, the skin and connective tissue becomes less elastic and the thin skin on the eyelid can no longer be pulled up completely.
This usually occurs on both sides and there is also a family history of this condition. However, drooping eyelids are not only a change of age, but can also be congenital. Children with drooping eyelids are usually a congenital disorder.
Either the responsible cranial nerve is not properly developed or the eyelid muscle is not properly developed. Various chronic diseases can also lead to unilateral or bilateral drooping eyelids. These diseases can affect both the muscles, in this case the eyelid lifter, and the nerves.
One such disease is the neuromuscular disease myasthenia gravis. However, those affected usually have other symptoms as well. If drooping eyelids occur suddenly, a doctor should be consulted as soon as possible or the emergency medical services should be called.
A stroke can be the cause of other hemiplegic symptoms in particular and in this case immediate treatment in a neurological clinic is necessary. Other possible causes of a suddenly drooping eyelid are encephalitis or meningitis. In this case, too, immediate medical treatment is necessary.
Children can also have strokes, which is why a doctor should always be consulted here as well. If only one eyelid hangs, the causes can be narrowed down somewhat. A pure age weakness of the skin is rather unlikely.
Especially in the case of sudden occurrence, neurological diseases must be excluded. The most common cause is a stroke caused by a blocked blood vessel and is one of the most common diseases in Germany that trigger a need for care. A differentiation must first take place in the clinic, since it is always an emergency, which makes immediate hospital treatment necessary.
The cause for the one-sided restriction is the anatomy of the brain. The human brain is built in two halves, each controlling the opposite half of the body. Most areas of the brain are therefore duplicated.
In the case of damage, such as a stroke, often only one hemisphere of the brain is affected and its function is accordingly restricted. In a typical stroke caused by a blocked blood vessel, the damage often remains one-sided, while inflammation can spread to the entire brain. In congenital ptosis, a drooping eyelid can also be unilateral, as both sides do not necessarily have to show a developmental disorder.
Even in the case of slow development of a drooping eyelid, an imaging examination of the head should be performed, since space-occupying structures such as abscesses or tumors that exert pressure on one side should be excluded. In congenital ptosis, a drooping eyelid may also be present on one side, since both sides do not necessarily have to show a developmental disorder. Even in the case of slow development of a drooping eyelid, an imaging examination of the head should be performed, since space-occupying structures such as abscesses or tumors exerting pressure on one side should be excluded.
- Strokes
- Cerebral hemorrhages
- Encephalitis
The thyroid gland is a normally soft, small organ in the neck area. With changes such as a large goiter or thyroid cancer, this organ can grow greatly in size. It is possible that other structures, such as nerves, are affected.
The thyroid gland can, for example, restrict the sympathetic nervous system of the head. If this sympathetic nervous system fails, the affected person shows a number of neurological deficits. These include Horner’s syndrome, which consists of a drooping eyelid (ptosis), a small pupil (miosis) and a sunken eyeball (enophthalmos).This is usually a unilateral disorder, since the sympathetic nervous system is also located on both sides and only one area is constricted.
In addition to the drooping eyelid, hoarseness, difficulty swallowing and a clearly palpable and visible thyroid gland often occur. In case of ptosis and other symptoms listed above, a medical examination is necessary. In the case of known thyroid gland changes, regular ultrasound scans should be performed by your family doctor.
At an older age, this is one of the normal check-ups at the family doctor. Botox is a strong neurotoxin produced by the bacterium Clostridium botulinum. In cosmetic surgery, this nerve poison is sometimes used to tighten skin folds.
If Botox gets close to nerves, they can become paralyzed, which leads to failures in the areas to be treated. This can also affect the eyelid lifter during facial treatments. Botox poisoning from food also leads to nerve paralysis throughout the body.
The first to be affected are small muscles. An early sign is double vision and drooping eyelids can also occur in the early stages. In case of sudden double vision and ptosis after consumption of canned food a doctor should be consulted immediately.
Muscle weakness can be caused by a chronic disease as well as by age. A possible disease of the muscles that can lead to drooping eyelids is myasthenia gravis. This often occurs in childhood.
The muscle weakness can also be a consequence of nerve-damaging toxins. This has been observed with Botox and also with some snake venoms. In old age there is often no specific cause for the slackening of the singer.
Stress can cause many consequences in the body. Stress can act as a risk factor for strokes and other circulatory disorders, and can also cause ptosis as a secondary cause. Also in known neuromuscular diseases, increased stress can trigger a surge and also secondarily lead to drooping eyelids.
However, a direct connection between increased stress and drooping eyelids is not known. A stroke is either a blocked blood vessel in the brain or a bleeding. In both cases, there is an undersupply and a death of nerve cells on one side.
Depending on the localization in the brain, various symptoms of failure are possible. The best known picture is the so-called hemiplegia, which also affects the eyelid muscle. Those affected have a drooping eyelid and often the entire half of the face paralyzed. A stroke is a very time-critical emergency and the failures can only be reversed with timely treatment, so in case of a sudden ptosis the emergency services should be called. In some patients, the symptoms of failure, including ptosis, remain for life.
